Healthcare Provider Details

I. General information

NPI: 1225099443
Provider Name (Legal Business Name): JEFFREY B. SYME M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 04/27/2020
Certification Date: 04/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

479 SWANSEA MALL DR
SWANSEA MA
02777-4119
US

IV. Provider business mailing address

200 MILL RD STE 180
FAIRHAVEN MA
02719-5252
US

V. Phone/Fax

Practice location:
  • Phone: 508-973-1570
  • Fax: 508-973-1545
Mailing address:
  • Phone: 508-973-2000
  • Fax: 508-973-2001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number6179
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number79711
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: